Safety of mucous fistula refeeding in neonates with functional short bowel syndrome: A retrospective review

Elliott, Tessa; Walton, J. Mark

doi:10.1016/j.jpedsurg.2019.01.050

Cited by 16 publications

(14 citation statements)

References 14 publications

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“…MFR is the practice of collecting proximal ostomy e uent and reinfusing it into the distal mucous stula. It can prevent atrophy of the distal bowel and promote uid and nutrient absorption [6,7]. In previous retrospective studies, MFR was proven as a safe technique that helped in promoting infant growth and discontinuing PN [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of mucous fistula refeeding in preterm infants: An exploratory randomized controlled trial

Lee

Kim

Shin

et al. 2022

Preprint

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Background: This study aimed to evaluate whether mucous fistula refeeding (MFR) is safe and beneficial for the growth and intestinal adaptation of preterm infants with enterostomies.Methods: This exploratory randomized controlled trial enrolled infants born before 35 weeks’ gestation with enterostomy. If the stomal output was ≥ 40 mL/kg/day, infants were assigned to the high-output MFR group and received MFR. If the stoma output was < 40 mL/kg/day, infants were randomized to the normal-output MFR group or the control group. Growth, serum citrulline levels, and bowel diameter in loopograms were compared. The safety of MFR was evaluated.Results: Twenty infants were included. The growth rate increased considerably, and the colon diameter was significantly larger after MFR. However, the citrulline levels did not significantly differ between the normal-output MFR and the control group. One case of bowel perforation occurred during the manual reduction for stoma prolapse. Although the association with MFR was unclear, two cases of culture-proven sepsis during MFR were noted.Conclusions: MFR benefits the growth and intestinal adaptation of preterm infants with enterostomy and can be safely implemented with a standardized protocol. However, infectious complications need to be investigated further.Trial registration: clinicaltrials.gov NCT02812095, retrospectively registered on June 6, 2016.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of mucous fistula refeeding in preterm infants: An exploratory randomized controlled trial

Lee

Kim

Shin

et al. 2022

Preprint

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“…Elliott and Walton quantified minor complications associated with MFR and noted that there was one (3%) mucous fistula prolapse, one (3%) enterocutaneous fistula, and four (13%) patients who developed redness around the mucous fistula site. 13 This group also highlighted the burden of catheter replacement and pump occlusion during MFR. Other described complications commonly included backflow of refeeding contents, displacement of the catheter, and mucous fistula-related events.…”

Section: Resultsmentioning

confidence: 99%

“…This technique requires skilled nurses and time; with growing pressures on health care, it is estimated that MFR requires ∼30 to 35 minutes dedicated nursing time per 12-hour shift. 13 MFR and the number of neonates within the literature suitable for this intervention suggest that it is not a frequently performed practice to allow required training in MFR. Furthermore, minor complications such as thick stoma output, prolapse, and backflow may also lead to a lack of perseverance with the technique and early abandonment.…”

Section: Discussionmentioning

confidence: 99%

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A Review on Safety and Outcomes of Mucous Fistula Refeeding in Neonates

2020

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Introduction The utility of mucous fistula refeeding (MFR) in neonates with short bowel syndrome is widely debated. Our purpose is to review MFR and outline methods, reported complications, and clinical outcomes (survival, weight gain, dependence on parenteral nutrition [PN], and time to enteral autonomy). Materials and Methods We performed a MEDLINE literature search and reference review from January 1980 to May 2020 for terms (“mucous fistula re-feeding” or “enteral re-feeding”) and neonates. We included studies that utilized conventional MFR in the neonatal period. Non-English language articles were excluded. Results We identified 11 relevant articles. Internationally, there was no consensus on methods of MFR. A total of 197 neonates underwent MFR. Within a single study, four neonates developed major complications; however, the procedure was well tolerated without major complications in 10 of the 11 studies. A mortality of nine patients during MFR highlights the burden of disease within the study population; however, of these, only one was directly attributable to MFR. Minor complications were seldom quantified. Three studies demonstrated a higher rate of weight gain and shorter PN support versus controls. Neonates who underwent MFR had lower chance of anastomotic leak and quicker progression to full feed after reversal versus controls. The influence of microorganisms in MFR was only investigated in one study. Conclusion Current evidence suggests benefits of MFR; however, an international consensus is yet to be reached on the optimal method. A large prospective study investigating the influence of MFR on the enteric system is required.

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“…При накладанні герметичних анастомозів може бути застосоване первинне анастомозування або декомпресивна ентеростомія за Бішоп-Купом [9]. Після підтвердження спроможності анастомозів дистального відділу тонкої кишки, шляхом проведення рентгенконтрастного дослідження, можливе введення кишкового вмісту з привідної стоми у відвідну для забезпечення безперервності інтестинального пасажу [4]. Крім того, цей метод дає можливість діагностики функціональної спроможності дистального по відношенню до атрезії відділу тонкої кишки та, потенційно, зменшити потребу у парентеральному харчуванні [4,5].…”

Section: дискусіяunclassified

Organ-preserving principles of reconstructive surgery for type IV intestinal atresia in newborns

Sliepov¹,

Migur²,

Ponomarenko³

2020

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Органозберігаючі принципи реконструктивних оперативних втручань при атрезії тонкої кишки ІV типу у новонароджених дітей ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук'янової Національної академії медичних наук України», м. Київ Paediatric surgery.Ukraine͘ϮϬϮϬ͘ϭΈϲϲΉ͗ϮϭͳϮϲ͖ K/ ϭϬ͘ϭϱϱϳϰͬW^͘ϮϬϮϬ͘ϲϲ͘Ϯϭ &Žƌ ĐŝƚĂƚŝŽŶ͗ ^ůŝĞƉŽ| K͕ DŝŐƵƌ D͕ WŽŶŽŵĂƌĞŶŬŽ K͘ ;ϮϬϮϬͿ͘ KƌŐĂŶͲƉƌĞƐĞƌ|ŝŶŐ ƉƌŝŶĐŝƉůĞƐ ŽĨ ƌĞĐŽŶƐƚƌƵĐƚŝ|Ğ ƐƵƌŐĞƌǇ ĨŽƌ ƚǇƉĞ /s ŝŶƚĞƐƚŝŶĂů ĂƚƌĞƐŝĂ ŝŶ ŶĞǁďŽƌŶƐ͘ WĂĞĚŝĂƚƌŝĐ ƐƵƌŐĞƌǇ͘hŬƌĂŝŶĞ͘ϮϬϮϬ͘ϭ;ϲϲͿ͗ϮϭͲϮϲ͖ ĚŽŝ ϭϬ͘ϭϱϱϳϰͬW^͘ϮϬϮϬ͘ϲϲ͘Ϯϭ

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Safety of mucous fistula refeeding in neonates with functional short bowel syndrome: A retrospective review

Cited by 16 publications

References 14 publications

Efficacy and safety of mucous fistula refeeding in preterm infants: An exploratory randomized controlled trial

Efficacy and safety of mucous fistula refeeding in preterm infants: An exploratory randomized controlled trial

A Review on Safety and Outcomes of Mucous Fistula Refeeding in Neonates

Organ-preserving principles of reconstructive surgery for type IV intestinal atresia in newborns

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